Surgical clamp

ABSTRACT

To obtain better cosmetic results after surgical operations and to reduce scarring and eliminate the infection risks of suturing holes, a spring actuated clamp (1) having compression surfaces (5&#39;) with flat or rounded protuberant parts (7) is provided. The surgical clamp prevents perforations of the skin and at the same time provides for a good securing of the clamp to the skin.

BACKGROUND OF THE INVENTION Field of the Invention

After every surgical operation, the healing of the wound has greatimportance. Attempts have therefore been made to create the optimalpreconditions for the most risk-free, painless, and rapid healing. It isknown that wounds, the cutting edges of which have been held together bymeans of clamps or threads, heal more rapidly and cosmetically moreattractively than wounds which are allowed to heal by themselves(Williams and Harrison, 1977). In many specialties of medicine, clampingtechniques have their fixed place next to suture techniques,particularly in gynecological and abdominal operations. Recently,clamping techniques have again found increasing application in variousother fields. These offer many technical and medical advantages incomparison with suture techniques. During their application the rates ofinfection are lower, granulomas do not arise as frequently, and theaverage hospital stay of the patient is thus shorter (Beresford et al,1984). In the case of dermal inflammations, clamping is thereforepreferred, because it is much faster than the application of a threadsuture. The skin transplant can be placed more rapidly, and the criticalanesthesia time can therefore be reduced (Kahn et al, 1984; Hallock etal, 1984 ). Stephens and Niesche (1974) recommend skin clamping forwound closures during abdominal operations, neck operations, breast andthorax operations, and Nockemann (1968) recommends it for skin closuresafter thyroid operations. According to Swanson (1982), clamping issuited on the scalp, on the face, and on the extremities. Through thetraumatization of the tissue, which is reduced in comparison with threadsuturing, clamping provides a more attractive healing of the wound and aslighter formation of scars. According to Nockemann (1965/1968), suturesleave scars at the puncture points, as well as at the points where thethread has been laced or compressed with the tissue for a period oftime. These scars can be very irritating to the skin, and haveunattractive effects. Attempts have therefore been made to keep the sizeand number of puncture points as small as possible and to entirely avoidlines of scar tissue pressure points, which are caused by the thread,and which produce the known Strickleiter syndrome.

These attempts led to the closure of wounds of the skin by means ofclamps. Their application and removal is simple and fast. In addition,the danger of bacterial colonization on the metal of the clamps isslight, since the germs adhere poorly to the smooth surface, and themetal furthermore has its own, germ-killing, bactericidal effect. Incontrast to this, the use of suture materials in the wound increases therisk of the virulence of the staphylococci by some 10,000-fold. Theabscess rate is about three times less with the clamping technique.According to Stephens (1970), wounds closed with clamps showed, on the7th post-operative day, better mechanical properties than those closedby means of a suture thread; that is, the coefficient of elasticity isgreater, the breaking strength is higher, and the capacity for energyabsorption without rupture is better. Lowdon et al (1980) also foundthat the post-operative complications in the form of anastomosisweakness, wound infections, and hemorrhages were about 25% rarer whenusing clamps. An experiment by Meiring (et al, 1982) on each of 20patients also showed, that the wound closure by means of clamping wasabout 80% faster, and could also be carried out more simply, than wasthe case with a conventional threaded suture.

These numerous and evident advantages show the fundamental significanceof the clamping technique, which has been used in place of suturetechniques in most clinics in the USA. Nevertheless, the clamps mostcommonly used today still have decisive defects, which must beeliminated.

DESCRIPTION OF THE PRIOR ART

Conventional clamps for application to all parts of the body, with theexception of the scalp, without exception puncture both sides of theskin on the wound to be held together, and at several places. For onething, this puncturing is painful for the patient, and, for another, itis undesirable for medical reasons. In addition to cosmeticdisadvantages from the punctures, these above all else increase thedanger of infection, since foreign material penetrates into the wound.Furthermore, the removal of the clamps requires, in many clampingsystems, a special device, which is not structured simply and istherefore time-consuming.

A skin clamp is already known in the technical trade, which does notpuncture the parts of the skin which are to be held together. This clampis only used in neurosurgery, for trepanation. It is only usedtemporarily, that is, only for the crude clamping away of the bloodvessels during the operation, since, in neurosurgery, massive bloodlosses must be taken into account. This clamping away squeezes andtraumatizes the skin very badly, but the loss of blood can be restrictedin this way. This clamp thus differs from the wound clamp in accordancewith the invention, both as to function and operational goals.Furthermore, it can, for the reasons stated above, only be used duringthe operation, and not afterwards, such as, for example, for closure ofthe wound. It can only, because of its construction, only be applied tothe scalp, since it only allows a very slight spreading, and thereforecan only be used where the subcutaneous layer is very thin, and liesdirectly on the bone (skull).

Furthermore, this skin clamp, for application as well as for removal,must be operated by means of special tongs. The compression edges ofthis scalp clamp are formed in a corrugated manner, so that oneconvexity of the shaft fits into the convexity of the opposing side.This causes traction and compression forces on the skin, which work indifferent directions, and, when left for longer periods on the skin, canleave behind scar-like traces.

SUMMARY OF THE INVENTION

It is the goal of the present invention to eliminate the stateddisadvantages of the conventional clamps while maintaining thefundamental advantages of the clamping technique, and to create a skinclamp, which can be applied to all parts of the body simply and withoutpuncturing the skin.

This task is, in accordance with the invention, solved by means of awound clamp comprising two clamp parts movable relative to one another,each clamp part having a handle, with the handles compressible towardone another to open the clamp. Each clamp part has a claping surface,and the clamping surfaces are aligned with and directed toward oneanother. Each clamping surface is provided with corrugated comprissionedges, with the protuberant parts of the clamping blade corrugated edgesaligned with one another.

Exemplary embodiments of the wound clamp with the invention are depictedin the following diagrams, which, for the sake of clarity, are shown onan enlarged scale. These show the following:

FIG. 1: a perspective view of a wound clamp having two parts which canbe pivoted against one another;

FIG. 2a-2e advantageous formations of the compression edges of the clampparts;

FIG. 3: a perspective view of two displaceable clamp parts;

FIG. 4: a frontal view of a clamp comprising a flat spring constructedfrom the wound clamp parts from FIG. 3;

FIG. 5: a front view of a clamp comprising a compression spring and theclamp parts shown in FIG. 3;

FIG. 6: a front view of a clamp comprising a tension spring and theclamp parts shown in FIG. 3;

FIG. 7: a perspective view of a wound clamp comprising a driving rod.

DESCRIPTION OF PREFERRED EMBODIMENTS

The embodiment of the wound clamp shown in FIG. 1 is constructedaccording to the clothespin principle, that is, both clamp parts (1) arepositioned to pivot with respect to one another on a common axis (2). Atorsion spring (3), which is provided around the axis (2), presses thesides of the clamp parts (1), which are formed as handles, away from oneanother, and thus correspondingly presses the clamping blades (5)against one another. This construction permits, through the applicationof the law of leverage, a large spreading of the clamping blades (5),with comparatively smaller swivelling of the handles (4). Furthermore,the handles (4) can be held with just two fingers, and the clamp istherefore simple to operate. The compression edges (6) of the clampingblades (5), which are intended to come into contact with the skin are,in this embodiment, formed in a corrugated manner. The corrugation peaks(7) of the compression edges which oppose one another are alignedopposite. The roundings of the corrugation peaks prevent, on the onehand, a puncturing of the skin, and, on the other, they increase thespecific pressure on the skin, and thereby improve the adhesion of theapplied clamp in comparison with straight edges. A further advantage ofthis embodiment consists of the fact that the clamp for post-operativeswellings in the area of the suture of the wound allows sufficient spaceabove the compression edges. There are clamp systems in which this isnot the case, and which therefore leave traces in the scar, which areknown under the name of "Strickleiter syndrome". The clamp blades (5)extend from the axis (2) in a curved line externally. In the lowestarea, the clamp blades are angled at about 90° inwardly, so that theclamping blade surfaces (5') lie in a plane with the clamping blade.This plane touches the skin somewhat tangentially. The compression edges(6) of the clamping blade surfaces (5') thereby move the wound edgesroughly parallel to the surface of the skin.

In FIG. 2, further examples of advantageous compression edges (6) on theclamping blades (5) are shown. All these embodiments are so constructedthat they never puncture the skin, but nonetheless guarantee asatisfactory adhesion of the clamp to the skin, so that only theepithelial layer of the skin, at the most, is ever traumatized.

FIG. (2a) shows compression edges with semi-circular peaks (8) facingone another, which have a specific distance (9) from one another. InFIG. (2b), the compression edges have short, straight protuberant parts(10) with rounded corners, which are likewise positioned at a certaindistance (9) from each other. In FIG. (2c), the protuberant parts areformed by circular segments (11), which are arranged in rows in serieswith each other. The arrangements in FIGS. (2d) and (2e) showprotuberant parts, which are formed by corrugated peaks (7) of shaftswith varying radii of curvature.

In FIG. 3, two wound clamping parts (12) for a particularly flat woundclamp are shown in a perspective view. Both parts consist of perforatedplates, from which clamping surfaces are formed by two separaterectangular surfaces extending toward one another while, on the otherend of the wound clamp parts (12), handles are set vertical to theclamping surfaces (13). The one handle (14) is thus narrower, and isformed as a tab, which, through the shifting of its foot unit (15)around a metal plate thickness upwardly, fits into a correspondingaperture (16) in the other clamping part (17), where it locates easily,particularly when guides (18) provided on one clamp part, are insertedinto the corresponding grooves (19) provided on the other clamp part. Ifthe handles (4) are now pressed toward one another, then the clampingsurfaces shift in a plane parallel to one another.

A flat spring (20) inserted between the handles (4) ensures, inaccordance with the embodiment shown in FIG. 4, the closing of both theclamping surfaces, which presses these handles away from one another,and thereby presses the compression edges (6) against one another. InFIG. 5, this function is achieved by a compression spring (21), which,is mounted on pegs (22), which extend in a manner aligned with oneanother, and have about 1/3 of the length of the compression spring. Thepressing together of the compression edges (6) can also be attained bymeans of a tension spring (23) suspended between the clamp parts (17).

The handles (4) in FIG. 4 and FIG. 6 are moreover provided with hinges(24), which make possible a folding under of the handle (4) after theapplication of the wound clamp. The construction according to FIGS. 3 to6 makes possible a particularly flat wound clamp. The side walls (25) ofthe rectangular clamp parts (12) must be high enough to afford space fora possible swelling of the wound. If the handles (14) are additionallyalso hingeable, the entire height of the clamp is, in relation to thewidth, particularly advantageous. This is of importance if a connectionis applied over the clamps, but the pressure on the clamps is reduced,and there is also no danger of tipping from forces which are exerted bythe connection on the clamp. At the same time, the specific contactpressure is also reduced by the size of the clamping surfaces (13)provided on both handles (4) which additionally give the applied woundclamp further stability as well. The parallel guidance of the clampingparts (17) helps the wound to only be pressed together at the skinsurface, which facilitates a slighter degree of scar formation.

In FIG. 7, a particularly advantageous embodiment of the invention isdepicted. The clamping parts (12) each have, parallel to the clampingdevice, two driving rods (27), which in the opposing clamping parts, areconducted through an aperture (26). This total of four apertures (26)gives the four driving rods (27) guidance, and ensures that, uponpressing the handle (4) attached to it together, the clamping parts (12)are pushed apart, parallel from one another. The handles (4) consisthere of round steel units, around which the ends of the driving rods(27) are bent in a groove provided for the purpose. When the clampingparts (12) the pressed apart from one another, the torsion spring (23)suspended between these parts (12) is extended. The application of thewound clamp then follows by releasing the handles (4), so that both theclamping parts (12), by virtue of the tension spring (23), are pressedagainst one another.

The simple form makes possible a low-cost production and mounting of theclamp. These new wound clamps can also be made from inert stainlesssteel. The use of other materials, such as, for example, plastics, ispossible.

Many advantages are connected with the fact that this new skin clampdoes not puncture the skin at any place. First of all, the pain for thepatient is considerably reduced; secondly, a cosmetically superiorresult is attained, since no permanent puncture points or scarring frompuncture points appear. For medical reasons, the substantially lowerdanger of infection is important, since it is thereby ensured thatforeign material now only comes in contact with the surface of the skin,and no longer comes in contact with the tissue and the wound. As afurther advantage relative to different conventional clamping systems,there should be mentioned the fact that, because of the construction ofthe new skin clamp, space remains for the tissue to expand in event ofpossible post-operative swelling. Since the wound clamp in accordancewith the invention can be spread very far apart, its application to allparts of the body is possible. Its application, as well as its removal,is accomplished by means of just two fingers, and without the use ofauxilliary instruments.

I claim:
 1. A wound clamp for holding together the edges of woundsduring the healing process comprising:two clamp parts (12) which aremovable relative to one another, each said clamp part having a handle(4), said handles (4) movable toward one another to open said woundclamp, said clamping parts (12) each having a clamping surface (13),said clamping surfaces (13) extending in the same plane and directedtoward one another, said clamping surfaces (13) having corrugatedterminal compression edges with protuberant portions of said compressionedges aligned with and opposite one another; corresponding elements ofsaid clamp parts movable in a parallel-displaceable manner relative toone another in said plane, and a spring is provided whereby saidmovement of said clamp parts toward one another in at least onedirection is spring actuated; and each said clamping part (12) havingtwo driving rods (27) positioned in parallel, each said driving rodconducted through an aperture (26) in the other wound clamping part,said handles being attached at the ends of said driving rods and saidspring comprising a tension spring.
 2. A wound clamp for holdingtogether the edges of wounds during the healing process comprising:twoclamp parts (12) which are movable relative to one another, each saidclamp part having a handle (4), said handles (4) movable toward oneanother to open said wound clamp, said clamping parts (12) each having aclamping surface (13), said clamping surfaces (13) extending in the sameplane and directed toward one another, said clamping surfaces (13)having corrugated terminal compression edges with protuberant portionsof said compression edges aligned with and opposite one another;corresponding elements of said clamp parts movable in aparallel-displaceable manner relative to one another in said plane, anda spring is provided whereby said movement of said clamp parts towardone another in at least one direction is spring actuated; and saidspring comprising a tension spring (21) which draws said clamping parts(12) toward each other.
 3. A wound clamp for holding together the edgesof wounds during the healing process comprising:two clamp parts (12)which are movable relative to one another, each said clamp part having ahandle (4), said handles (4) movable toward one another to open saidwound clamp, said clamping parts (12) each having a clamping surface(13), said clamping surfaces (13) extending in the same plane anddirected toward one another, said clamping surfaces (13) havingcorrugated terminal compression edges with protuberant portions of saidcompression edges aligned with and opposite one another; said clampingparts (12) being provided with at least one locking device, whereby saidprotuberant portions of said corrugated compression edges are spaced ina closed position of said clamp.
 4. A wound clamp in accordance withclaim 3, wherein corresponding elements of said clamp parts are movablein a parallel-displaceable manner relative to one another in said plane,and a spring is provided whereby said movement of said clamp partstoward one another in at least one direction is spring actuated.
 5. Awound clamp for holding together the edges of wounds during the healingprocess comprising: two clamp parts (12) which are movable relative toone another, each said clamp part having a handle (4), said handles (4)movable toward one another to open said wound clamp, said clamping parts(12) each having a clamping surface (13), said clamping surfaces (13)extending in the same plane and directed toward one another, and saidclamping surfaces (13) having corrugated terminal compression edges withrounded protuberant portions of said compression edges aligned with andopposite one another.
 6. A wound clamp for holding together the edges ofwounds during the healing process comprising:two clamp parts (12) whichare movable relative to one another, each said clamp part having ahandle (4), said handles (4) movable toward one another to open saidwound clamp, said clamping parts (12) each having a clamping surface(13), said clamping surfaces (13) extending in the same plane anddirected toward one another, said clamping surface (13) havingcorrugated terminal compression edges with protuberant portions of saidcompression edges aligned with and opposite one another; correspondingelements of said clamp parts movable in a parallel-displaceable mannerrelative to one another in said plane, and a spring is provided wherebysaid movement of said clamp parts toward one another in at least onedirection is spring actuated; and each said clamping part (12) beingformed by an L-shaped metal sheet, one leg of said L forming saidclamping surface (13) and the other leg of said L forming a side wall,said side wall having two apertures (26) providing guidance for drivingrods (27).
 7. A wound clamp in accordance with claim 5, wherein saidclamping parts are pivotable with respect to one another around a commonpivot axis (2), and a torsion spring (3) is provided around said pivotaxis.
 8. A wound clamp in wherein said spring comprises a flat
 9. Awound clamp in accordance with claim 4, wherein said spring comprises acompression spring, said handles (4) of the wound clamp are providedwith pegs (22) aligned with and extending toward one another, and saidspring is retained on on said pegs (22).
 10. A wound clamp in accordancewith claim 3, wherein said handles (4) are provided with hinges (24)whereby said handles are pivotable.
 11. A wound clamp in accordance withclaim 3, wherein said locking device is adjustable as to said spacedwidth.
 12. A wound clamp in accordance with claim 3, wherein saidprotuberant parts of said corrugated terminal compression edges aregenerally rectangular.
 13. A wound clamp in accordance with claim 6,wherein said handles (4) are attached at the end of said driving rods(27) and said movement is actuated by a tension spring (23).
 14. A woundclamp in accordance with claim 13, wherein said driving rods (27) areformed by bars folded perpendicular from upper portions of each saidside wall of said clamping parts (12).
 15. A wound clamp in accordancewith claim 14, wherein said bars have curved portions which cannot passsaid apertures thereby forming locking means maintaining saidprotuberant portions of opposite said compression edges spaced in aclosed position of said clamp.
 16. A wound clamp in accordance withclaim 6, wherein said driving rods (27) are formed by bars foldedperpendicular from upper portions of each said side wall of saidclamping parts (12).
 17. A wound clamp in accordance with claim 16,wherein said bars have curved portions which cannot pass said aperturesthereby forming locking means maintaining said protuberant portions ofopposite said compression edges spaced in a closed position of saidclamp.